The Coronovirus Disease 2019 –(COVID-19) pandemic had a significant impact on the health care system and medical staff around the world. The orthopedic units were also subject to new restrictions and regulations. Therefore, the aim of our research was to assess how the COVID-19 pandemic affected orthopedic wards in the last year in Poland. We created an online survey, which was sent to 273 members of the Polish Society of Orthopedics and Traumatology. The survey contained 51 questions and was divided into main sections: Preparedness, Training, Stress, Reduction, Awareness. A total of 80 responses to the survey were obtained. In Preparedness section the vast majority of respondents (90%) replied, that they used personal protective equipment during the pandemic, however only 50% of the respondents indicated that their facility received a sufficient amount of personal protective equipment. Most of the respondents indicated that the pandemic negatively affected the quality of training of future orthopedists (69.4%) and that pandemic has had a negative impact on their operating skills (66,7%). In Reduction section most of the doctors indicated that the number of patients hospitalized in their departments decreased by 20–60% (61,2% respondents), while the number of operations performed decreased by 60–100% (60% respondents). The negative impact of pandemic on education was noticeable especially in the group of young orthopedic surgeons: 0–5 years of work experience (p = 0,029). Among the respondents, the level of stress increased over the last year from 4.8 to 6.9 (p <0.001). The greatest increase in the level of stress was observed among orthopedists working in country hospitals (p = 0,03). In section Awareness 36,3% of respondents feel well or very well informed about the latest Covid-19 regulations. In addition, most doctors (82.6%) believe that the Polish health care system was not well prepared to fight the pandemic and that the regulations applied so far are not sufficient to effectively fight the pandemic (66.2%). The COVID-19 pandemic has impact on orthopedics departments in Poland and negatively affected the quality of training of orthopedic surgeons and the level of stress.

Background: The COVID-19 pandemic has affected all of the medical specialties, including orthopedic oncology. Therefore, the aim of the study was to assess how it influenced the diagnostic and therapeutic processes for patients with bone neoplasms. Methods: We evaluated 87 patients treated due for bone neoplasms before (Group I, n = 36) and during the COVID-19 pandemic (Group II, n = 51). A delay in diagnosis was defined as the period between the initial clinical symptoms and the date of referral to an oncology center. The patients from Group II were asked to complete a short questionnaire regarding the COVID-19 pandemic. Results: The median general delay in diagnosis before the pandemic was 7 months, while during the pandemic, it was 10 months (p = 0.728). The biopsy delay was lower in the pre-pandemic group: median-6.5 vs. 12 days (p = 0.025). The patients from Group II were diagnosed with larger tumors compared to those in Group I: the median values were 75 vs. 56 mm (p = 0.025), respectively. After an X-ray examination, the bone neoplasms were suspected more frequently in the Group II: 63% vs. 44% cases (p = 0.024), respectively. In Group II, 20 (60.8%) cases of SARS-CoV-2 infection were reported, however, no respiratory failure cases were noticed. Conclusion: The pandemic affected the diagnostic process of primary bone tumors, resulting in delays in performing biopsies. During the pandemic, the patients reported larger diameters of their bone lesions.

Multitrauma is defined as injury involving two or more different body parts, with a condition that at least one of these injuries is life-threatening. They represent serious traumas, requiring treatment in the intensive care units and frequently surgical intervention. The objective of this study was epidemiological and clinical analysis of patients treated in 2015 year in Multitrauma Centre of the University Teaching Hospital no 1 in Szczecin, and comparison the results with outcomes of similar study conducted in the same Centre in 2007 year. Clinical material comprised medical notes of 82 patients, 52 men (63%) and 30 women (37%), with a mean age of 44 years, who sustained multitrauma injuries. An analysis included causes of traumas, spectrum of injuries, involvement of body parts, methods and outcomes of the treatment. Results. The most common cause of multitrauma was traffic accident - 45 cases (55%), followed by fall from height - 22 (27%) and other mechanism - 15 (18%). The most frequent component of multitrauma made bone fractures (spine, pelvis, limbs) - 64 cases (78%), followed by head traumas - 63 (77%), chest - 53 (65%) and abdominal 30 (36%) injuries. A total of 48 patients (58%) required surgical intervention, the most frequently fixation of bone fractures - 24 patients (29%), repair of abdominal and head injuries - 18 (22%) either. Of 82 treated patients 64 (78%) survived and 18 (22%) died. A mean period of stay in Multitrauma Centre was 23 days for survived patients and 17 days for those who died. Comparing to similar analysis conducted 8 years earlier, a change in involvement of particular body parts comprising multitrauma injury was observed: number of head injuries increased of 14%, number of chest traumas and bone fractures decreased of 21% and 11%, respectively. The survival rate improved of 10%.

The pattern of traumatic death is a subject of great interest in the worldwide literature. Most studies have aimed to improve trauma care and raise awareness of avoidable fatal complications. The objective of present study was an epidemiological and clinical analysis of causes of traumatic death of the patients treated in Multitrauma Centre of the University Teaching Hospital no 1 in Szczecin, over a period of 3 years (2017-2019). Material of the study comprised of medical data of 32 patients in a mean age of 63 years, who died following polytrauma injury. Time of death form admission to the Multitrauma Centre, primary cause of death, spectrum and sites of injuries, as well as method of treatment (operative or conservative) were variables considered in the analysis. Results. The predominant mechanisms of injury were traffic accidents - 22 cases (69%) followed by falls from height 8 (25%) and other mechanism - 2 cases (6%). The most common primary cause of death was brain injury - 17 patients (53%) followed by pelvic or spine fractures - 5 (16%). The predominant constituents of polytrauma were bony injuries (pelvis, spine and limbs) - 28 cases (87%), followed by head injuries - 25 (78%), chest - 24 (75%) and abdominal injuries - 17 (53%). Eighteen patients (56%) required operative treatment; craniotomy for brain injuries was the most commonly performed - in 11 patients followed by laparotomy - in five. Five other patients underwent endovascular procedure - embolization of pelvic arteries. Twelve patients (38%) died in the first two days from admission to the trauma centre, five (16%) in the first week and 15 later than one week form admission. Conclusions. Head injuries, pelvic fractures with associated retroperitoneal bleeding and severe injuries affecting several body parts were identified to be the most dangerous for polytrauma patients’ survival. A trend to decrease mortality due to haemorrhagic shock was observed, but it remains unchanged for central nervous system injuries.